By: Sara Arce, LMHC, CAP, Director of Family Services

What defines a family varies on a person’s culture, belief systems, and circumstances, and is not necessarily stagnant over time. Family can take on many forms extending beyond the nuclear family one was born into or raised. Whatever the make-up of the family, it is an emotional system where each member influences one another. In family therapy, the effects of addiction and mental illness are viewed as “a family disease,” and impacting all family members even if they are not directly involved. Loved ones of a person suffering from an addiction or mental illness can become overwhelmed and may experience stress and anxiety affecting their health and life satisfaction; leading to poor sleep, sadness, excessive worrying, embarrassment, isolation and can cause interpersonal issues in other relationships as well as affect personal responsibilities.

When treating persons with the disease of addiction or mental illness, families have a complex role as they provide emotional and financial support but also must be able to set clear expectations and boundaries and implement consequences. Communication and limits are common areas of family interaction where issues are identified that contribute to relationship discord or accommodate dysfunction of an individual.  Some examples of poor communication might include a family member speaking about another person instead of directly to them, answering for others assuming they know what the other person wants or needs, or using language that causes others to feel shame and guilt. When addiction or mental illness is present, it is not uncommon for relationships in the family to be enmeshed which is a result of unclear boundaries. For example, when a person attempts to solve the problems of another without allowing them to first take steps on their own, keeping secrets from other family members as a means of protecting someone’s feelings or negative consequences, or not respecting others personal space by insisting on frequent communication or visits. If left unresolved, these issues can cause resentment, frustration, and avoidance of serious problems in families.

While family members of people suffering from these illnesses want their loved one to get help, family systems instinctively also wish to maintain homeostasis, and each member plays a crucial role in doing that. When one family member changes, a shift naturally occurs in the behaviors of other members; this is the system’s way of self-regulating itself. When this change takes place families often need guidance in developing new communication strategies and relationship dynamics that are supportive of recovery and the system’s overall well-being and the independent functioning of its members. Without proper support and openness to the process, the family may not sustain these new changes after treatment. In time, the client and family can fall back into previous patterns of interaction that are not favorable for recovery, which could result in a relapse of substance use or mental health decompensation. It is for this reason that family therapy in treatment is so critical.

Aside from engaging in family therapy sessions, other resources are available, and everyone is encouraged to use these as part of their recovery process. Other resources include individual therapy, family support groups such as the Family Alliance Group offered to our affiliated families, or other community support groups such as Co-Dependents Anonymous and Al-Anon. The National Alliance on Mental Illness also provides various support groups throughout the nation and a targeted 12 session Family-to-Family course which is designed to empower individuals with skills and knowledge so they can better advocate for a loved one who is dealing with a mental illness. At Lifeskills, each client in the Residential or Partial Hospitalization Program is assigned a Family Therapist, a licensed professional who assesses the family’s needs by gathering information on family history, patterns, and roles and then provides ongoing therapy. We also offer an Intensive Therapeutic Family Weekend, which guides the family and client through the emotional process of healing, as well as educates them on their disorder and the clinical programming at Lifeskills.

Through psychoeducation, clinical guidance and practice, family members can learn to develop healthier communication and boundaries. Despite increasing awareness of the disease model of addiction and mental health illness, stigma is still a barrier for individuals and families seeking treatment. As a community, each and everyone one of us can contribute to reducing the stigma attached to addiction and mental illness by educating ourselves and removing shaming language from our vocabulary. If you or someone you know is dealing with mental health or substance abuse disorders, encourage them to seek help and support so that they and their family can begin the healing process.